異型上皮巣を伴う多発微小食道癌の1例

Multicentric Superficial Minute Esophageal Cancers with Foci of Atypical Squamous Epithelium, Report of a Case

要旨　ヨード染色法が有用であった多発微小食道癌の1例を経験した．患者は68歳，男性．定期検診目的で上部内視鏡検査を受診し，食道上切歯から32cmに境界鮮明な不整形の小発赤斑を指摘された．ヨード撒布像で境界鮮明な不染を呈し，生検病理診断は，扁平上皮癌であった．0-Ⅱc型，深達度m1を予想し，治療目的で本院に入院した．非開胸食道抜去術が施行され，新鮮標本，固定標本上の肉眼観察では全く病変を指摘しえなかったが，ヨード染色標本上で不染部，淡染部が食道全域に散在しており，病理組織学的検査により長径5mmのm2扁平上皮癌1病変，m1微小扁平上皮癌3病変と異型上皮6病巣を認めた．

　The patient, a 68-year-old man, was admitted to our hospital for a yearly endoscopic examination. Endoscopic examination showed superficial irregular reddness of esophageal mucosa which was clearly unstained by iodine. And also revealed scattered unstained areas in the aboral and adoral side of the main lesion. Histological examination of the biopsy specimens suggested squamous cell carcinoma. Blunt resection was performed for esophageal cancer. Macroscopic examination of the surgical specimen showed no change except for three areas clearly unstained by iodine. Histopathological observation of the resected materials showed multicentric squamous carcinoma scattered throughout the whole esophagus. One lesion had invaded only the epithelium, three lesions had invaded the lamina proprium with six atypical squamous epitheliums. This case indicated the close relation between carcinoma and atypical squamous epithelium of the esophagus.